Home > Refer a Life Insurance Advisor
Advisor Type *
—Please choose an option—New Advisor, requiring Life License sponsorshipExisting Advisor (select all that apply)
Requiring Life License sponsorship transferTransferring existing carrier contracts from another MGAApplying for new carrier contracts (no contract transfers from another MGA)
Contract Type Individual
Advisor Name (exactly as it appears on life license):
Corporate
Only choose this option if your corporation holds a corporate life license
Corporation Name (exactly as it appears on life license):
APEXA PROFILE Advisor Already Has An APEXA ProfileAdvisor Doesn’t Yet Have an APEXA Profile
Province/Territory *AlbertaBritish ColumbiaManitobaNova ScotiaNew BrunswickNewfoundland and LabradorOntarioPrince Edward IslandQuebecSaskatchewanNorthwest TerritoriesNunavutYukon
Advisor E-mail Address * Advisor Phone Number * AGA Advisor Reports To (leave blank if not applicable) Branch Advisor Belongs To (leave blank if not applicable)
License/Sponsorship Information (select all that apply): This advisor requires Life License sponsorship
Advisor has never before held a Life LicenseAdvisor has held a Life License before but now requires sponsorship transfer
Life License
Upload a copy of the life license (optional) Life License Number:
Mutual Funds Registration
Mutual Fund Dealer Name *
RIBO/P&C License
Upload a copy of the P&C license (optional) RIBO/P&C License Number P&C Brokerage Name *
Mortgage License
Upload a copy of the mortgage license (optional) Mortgage Broker License Number Mortgage Brokerage Name *
Real Estate License
Upload a copy of the real estate license (optional) Real Estate Agent License Number Real Estate Brokerage Name *
Other
License Type *
Advisor Life Insurance Bonus Rate % * Advisor Segregated Fund Payout Rate % * Advisor Travel Insurance Payout Rate % *
Existing Carrier Contracts to be Transferred (select all that apply): Assumption Life
MGA Transferring From Existing Selling Code
Blue Cross
BMO Insurance
Canada Life
Canada Protection Plan
Desjardins Financial Security
Edge Benefits
Empire Life
Equitable Life
Foresters
GMS Insurance
Humania Assurance
iA Excellence
Industrial Alliance
ivari
La Capitale
Manulife Financial
RBC Insurance
SSQ Financial
Sun Life Financial
UL Mutual
Additional Details
Username or email address *
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